GOOD VISUAL OUTCOME AFTER LISTERIA MONOCYTOGENES ENDOGENOUS ENDOPHTHALMITIS

Endogenous endophthalmitis caused by <i>Aspergillus</i> species tends to be very aggressive, often leading to devastating visual outcomes. Historically, intravitreal amphotericin injections have played a central role in management, but with variable visual outcomes and a risk of toxicity. Limited reports suggest that use of intravitreal voriconazole is a safe and efficacious alternative, though these cases were treated with only few intravitreal injections. Here, we report a case of bilateral endogenous <i>Aspergillus</i> endophthalmitis treated with 8 intravitreal voriconazole injections in the right eye and 11 in the left eye with good best-corrected final visual outcome (20/50 right eye and 20/40 left eye).

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Endogenous endophthalmitis and liver abscesses

Acute Medicine Journal ◽

10.52964/amja.0538 ◽

2012 ◽

Vol 11 (1) ◽

pp. 27-27

Author(s):

S Koay ◽

◽

S Jain ◽

I Cropley ◽

H Petrushkin ◽

...

Keyword(s):

Risk Factors ◽

Early Diagnosis ◽

Diverticular Disease ◽

Visual Outcome ◽

Endogenous Endophthalmitis ◽

Medical Comorbidities ◽

Streptococcus Anginosus ◽

Liver Abscesses ◽

Good Visual Outcome ◽

Prompt Diagnosis

Abstract We present a case of endogenous endophthalmitis secondary to liver abscesses, in a patient with no previous medical comorbidities or risk factors for immunosuppression. The patient presented with acute painless loss of vision and feeling generally unwell. Investigations revealed Streptococcus anginosus-constellatus bacteraemia, and evidence of diverticular disease that likely predisposed to the liver abscesses. Due to prompt diagnosis and administration of antibiotics, the patient had a good visual outcome. This case highlights the importance of being aware of endogenous endophthalmitis, as early diagnosis and prompt administration of antibiotics will optimise visual outcomes.

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Visual outcome of endogenous endophthalmitis in Thailand

Scientific Reports ◽

10.1038/s41598-021-93730-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Preeyachan Lourthai ◽

Pitipol Choopong ◽

Dhanach Dhirachaikulpanich ◽

Kunravitch Soraprajum ◽

Warinyupa Pinitpuwadol ◽

...

Keyword(s):

Retrospective Chart Review ◽

Visual Outcome ◽

Post Treatment ◽

Endogenous Endophthalmitis ◽

Infectious Episode ◽

Hand Motion ◽

Phthisis Bulbi ◽

Causative Agents ◽

Corneal Decompensation ◽

The Mean

AbstractTo evaluate a 10-year visual outcome of endogenous endophthalmitis (EE) patients. A 10-year retrospective chart review of EE patients. Thirty-eight patients (40 eyes) were diagnosed with EE at the mean age of 42. Among the identifiable pathogens (71.1% culture positive), the causative agents were predominantly gram-negative bacteria (48.1%). The most common specie was Klebsiella pneumoniae (25.9%). About a quarter of the patients required surgical eye removal, and the remaining 45.7% had visual acuity (VA) worse than hand motion at one month after the infectious episode. The most common complication was ocular hypertension (52.5%). Poor initial VA was significantly associated with a worse visual outcome in the early post-treatment period (p 0.12, adjusted OR 10.20, 95% CI 1.65–62.96). Five patients continued to visit the clinic for at least ten years. One patient had gained his vision from hand motion to 6/7.5. Two patients had visual deterioration, one from corneal decompensation, and the other from chronic retinal re-detachment. Two patients developed phthisis bulbi, with either some VA perception of light or no light perception. Poor initial VA is the only prognostic factor of a poor early post-treatment visual outcome of EE.

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Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

European Journal of Ophthalmology ◽

10.1177/11206721211012848 ◽

2021 ◽

pp. 112067212110128

Author(s):

Mumin Hocaoglu ◽

Murat Karacorlu ◽

M. Giray Ersoz ◽

Isil Sayman Muslubas ◽

Serra Arf

Keyword(s):

Proliferative Vitreoretinopathy ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Clinical Stage ◽

Case Series ◽

Visual Outcome ◽

Attachment Rate ◽

Good Visual Outcome ◽

The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

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Rubeosis iridis and macular hemorrhages from multiple Corkscrew retinal vessels in a patient with NF1

European Journal of Ophthalmology ◽

10.1177/1120672121996636 ◽

2021 ◽

pp. 112067212199663

Author(s):

Marilyn A Márquez ◽

Claudio P Juárez ◽

Maria C Sánchez ◽

Jose D Luna

Keyword(s):

Intravitreal Bevacizumab ◽

Visual Outcome ◽

Neovascular Glaucoma ◽

Retinal Vessels ◽

Retinal Hemorrhages ◽

Fluorescein Angiogram ◽

Rubeosis Iridis ◽

Good Visual Outcome ◽

Av Malformation ◽

Sudden Decrease

Purpose: To report a case of a patient with NF1 presenting with ocular findings of AV malformation, multiple retinal hemorrhages, and neovascular glaucoma in the absence of retinal ischemia. Methods: Review of the medical record was conducted in accordance with the local IRBt. Results: A 60-year-old female patient with diagnosis of Neurofibromatosis type1 (NF1) and sudden decrease of vision in her left eye was found to have rubeosis iridis and high intraocular pressure (IOP). On fundus exam multiple corkscrew retinal vessels and retinal hemorrhages were present in her left eye. On Optical Coherence Tomography (OCT) the foveal hemorrhages appeared as outer layer hyperreflective retinal infiltrates whereas in the parafoveal area the hyperreflectivity was present between the RPE and neurosensory retina. Fluorescein Angiogram (FA) showed normal perfusion and no areas of leakage or ischemia. Treatment with anti-angiogenics in a timely manner correlated with a good visual outcome. Conclusions: We present a unique patient with NF1, rubeosis iridis, high IOP, and macular hemorrhages from multiple corkscrew retinal vessels in a well perfused retina, who underwent treatment with a single dose of intravitreal Bevacizumab and had an excellent response

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Good Visual Outcome Following Vitrectomy for Epiretinal Membrane With Foveal Tissue Herniation

Journal of VitreoRetinal Diseases ◽

10.1177/2474126417709382 ◽

2017 ◽

Vol 1 (4) ◽

pp. 278-280

Author(s):

Patrick Oellers ◽

Dean Eliott

Keyword(s):

Epiretinal Membrane ◽

Visual Outcome ◽

Good Visual Outcome

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Bacterial and Fungal Endophthalmitis

Clinical Microbiology Reviews ◽

10.1128/cmr.00113-16 ◽

2017 ◽

Vol 30 (3) ◽

pp. 597-613 ◽

Cited By ~ 92

Author(s):

Marlene L. Durand

Keyword(s):

Intravitreal Injection ◽

Systemic Infection ◽

Visual Outcome ◽

Diagnostic Techniques ◽

Medical Emergency ◽

Molecular Diagnostic ◽

Endogenous Endophthalmitis ◽

Molecular Diagnostic Techniques ◽

Permanent Loss ◽

Hematogenous Seeding

SUMMARY Endophthalmitis is a severe eye infection that may result in permanent loss of useful vision in the affected eye. Most cases are exogenous and occur as a complication of cataract surgery, an intravitreal injection, or penetrating ocular trauma. Endogenous endophthalmitis results from hematogenous seeding of the eye by bacteria or fungi, but bacteremia or fungemia may be transient and patients may present without symptoms of systemic infection. Nearly all endophthalmitis patients present with decreased vision, and some also have eye pain. Eye examination usually reveals a hypopyon and intraocular inflammation. Diagnosis is clinical, supported by cultures of the vitreous and/or aqueous or by blood cultures in some endogenous cases. Molecular diagnostic techniques have been used in research laboratories for pathogen identification in endophthalmitis and offer the possibility of rapid diagnosis, including in culture-negative cases. Intravitreal injection of antibiotics is the most important component of treatment; some cases also benefit from surgical debridement of the vitreous by a vitrectomy. The visual outcome depends partly on the pathogen: coagulase-negative staphylococcal endophthalmitis has a better prognosis than does streptococcal endophthalmitis, for example. Endophthalmitis is a medical emergency, and prompt diagnosis and treatment are essential for saving vision.

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Refractive and Visual Outcomes after Scleral Fixated Intraocular Lens Implantation in Children with Ectopia Lentis

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v12i1.22252 ◽

2020 ◽

Vol 12 (1) ◽

pp. 75-82

Author(s):

Regina Lalramhluni ◽

Soveeta Rath ◽

Ankita Shrivastav ◽

Prem Kumar Singh ◽

Rahul Mayor ◽

...

Keyword(s):

Intraocular Lens ◽

Visual Outcome ◽

Ectopia Lentis ◽

Corrected Visual Acuity ◽

Good Visual Outcome ◽

Induced Astigmatism ◽

The Mean ◽

The Stability ◽

Scleral Fixated Intraocular Lens

Introduction: This study was conducted to report the refractive and visual outcome after Scleral Fixated Intraocular Lens (SFIOL) implantation in children with nontraumatic ectopia lentis. Methods: Retrospective review of the medical records of 25 eyes of 15 patients who underwent SFIOL implantation in children with non-traumatic ectopia lentis. Results: The mean best corrected visual acuity (BCVA) before SFIOL implantation was 1.07 ± 0.9 logMar units [median: 0.9, Interquartile range (ΙQR): 0.415 to 1.555] which improved to 0.41 ± 0.33 logMar units (median: 0.22, ΙQR: 0.180 to 1.555) at two months postoperative follow up. In phakic group, the mean spherical refraction preoperatively was -12.04 ± 7.82 DS (dioptre sphere) (IQR: +16 to -5.875) and postoperatively was +0.93 ± 2.67DS (IQR: -0.375 to +2). In aphakic group, the mean spherical refraction preoperatively was +12.22 ± 2.05 DS and postoperatively was +1.2 ± 1.9 DS. The mean total astigmatism preoperatively was -6.44 ± 4.95 DC (dioptre cylinder) (median: 6, IQR: -10.50 to +2) and postoperatively was -1.47 ± 0.98 DC (median: -1.5, IQR: -2 to - 0.625 ). The mean IOL induced astigmatism was -1.01 ± 0.95 DC (median -0.75, IQR: -1.33 to - 0.25). The spherical refractive equivalent was within 2 Diopter (D) of the target refraction calculated preoperatively in 20 eyes and in five eyes it was more than 2 D. Conclusion: SFIOL implantation is associated with good visual outcome with a significant improvement in the refractive error. However, a longer follow up is required to assess the change of refraction and the stability of the SFIOL.

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An Eleven-Year Retrospective Study of Endogenous Bacterial Endophthalmitis

Journal of Ophthalmology ◽

10.1155/2015/261310 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 21

Author(s):

Takashi Nishida ◽

Kyoko Ishida ◽

Yoshiaki Niwa ◽

Hideaki Kawakami ◽

Kiyofumi Mochizuki ◽

...

Keyword(s):

Visual Outcome ◽

Causative Organism ◽

Ocular Involvement ◽

Bacterial Endophthalmitis ◽

Poor Visual Outcome ◽

Ocular Symptoms ◽

Good Visual Outcome ◽

The Mean ◽

Systemic Antibiotics ◽

Endogenous Bacterial Endophthalmitis

Purpose. To determine the clinical features, microbial profiles, treatment outcomes, and prognostic factors for endogenous bacterial endophthalmitis (EBE).Methods. The medical records of 27 eyes of 21 patients diagnosed with EBE for 11 years were reviewed. Collected data included age, site of infection, visual acuities (VAs), microbial profiles, and treatment regimen.Results. The mean age was 68.5 years. Gram-positive organisms accounted for 76.2%, while gram-negative ones accounted for 19.0%.Staphylococcus aureuswas the most common causative organism (52.3%) of which 72.7% wasmethicillin-resistant S. aureus. A final VA of ≥20/40 was achieved in 44% and 20/200 or better was in 64%. Eyes with initial VA of ≥20/200 (P= 0.003) and focal involvements (P= 0.011) had significantly better final VA. Initial VA (P= 0.001) and the interval between onset of ocular symptoms and intravitreal antibiotic injection (P= 0.097) were associated with final VA in eyes receiving intravitreal antibiotics.Conclusions. EBE is generally associated with poor visual outcome; however the prognosis may depend on initial VA, extent of ocular involvement, and an interval between onset of ocular symptoms and intravitreal antibiotic injection. Early diagnosis and early intravitreal injection supplement to systemic antibiotics might lead to a relatively good visual outcome.

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